Functional Neuroradiology


, Volume 54, Issue 3, pp 255-260

First online:

Perfusion-weighted MR imaging in persistent hemiplegic migraine

  • Isabelle MourandAffiliated withService de Neuroradiologie, Hôpital Gui de Chauliac Email author 
  • , Nicolas Menjot de ChampfleurAffiliated withService de Neuroradiologie, Hôpital Gui de Chauliac
  • , Clarisse Carra-DallièreAffiliated withService de Neuroradiologie, Hôpital Gui de Chauliac
  • , Emmanuelle Le BarsAffiliated withService de Neuroradiologie, Hôpital Gui de Chauliac
  • , Agathe RoubertieAffiliated withService de Neuropédiatrie, Hôpital Gui de Chauliac
  • , Alain BonaféAffiliated withService de Neuroradiologie, Hôpital Gui de Chauliac
  • , Eric ThouvenotAffiliated withService de Neuroradiologie, Hôpital Gui de Chauliac

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Hemiplegic migraine is a rare type of migraine that has an aura characterized by the presence of motor weakness, which may occasionally last up to several days, and then resolve without sequela. Pathogenesis of migraine remains unclear and, recently, perfusion-weighted imaging (PWI) has provided a non-invasive method to study hemodynamic changes during acute attacks.


Two female patients were admitted in our hospital suffering from prolonged hemiparesis. In both cases, they underwent MRI examination using a 1.5 T magnet including axial diffusion-weighted and perfusion sequences. From each perfusion MRI acquisition two regions of interest were delineated on each hemisphere and, the index of flow, cerebral blood volume, mean transit time, and time to peak were recorded and asymmetry indices from each perfusion parameter were calculated.


Perfusion alterations were detected during the attacks. In one case, we observed, after 3 h of left hemiparesia, hypoperfusion of the right hemisphere. In the other case, who presented a familial hemiplegic migraine attack, on the third day of a persistent aura consisting of right hemiplegia and aphasia, PWI revealed hyperperfusion of the left hemisphere. Asymmetry indices for temporal parameters (mean transit time and time to peak) were the most sensitive. These findings resolved spontaneously after the attacks without any permanent sequel or signs of cerebral ischemia on follow-up MRI.


PWI should be indicated for patients with migraine attacks accompanied by auras to assess the sequential changes in cerebral perfusion and to better understand its pathogenesis.


Hemiplegic migraine Familial hemiplegic migraine MRI Persistent aura